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Practicing Yoga for RA

Yoga offers big benefits such as increased flexibility and strength for people with rheumatoid arthritis, and poses can be modified to accommodate your individual needs. Give these RA-friendly yoga poses a try.

Dealing with rheumatoid arthritis can feel overwhelming, but yoga's powerful benefits — both physical and mental — may help put you back in control.

"Through yoga, we train our hearts and minds to be more at ease with the challenges of life, including the emotional challenges of chronic pain," explains Ariele Foster, PT, DPT, E-RYT, a Washington, D.C.-based physical therapist and yoga instructor.

Yoga is also a great exercise for people with RA because it's easy on the joints. "Most forms of yoga are low-impact, and they help joints stay mobile by working on flexibility," says Steffany Moonaz, PhD, a yoga therapist and researcher in Baltimore.

And while the research about the benefits of yoga for RA is though still fairly new and limited, it shows promise. A study published in the Clinical Journal of Pain in November 2013 found that twice-weekly practice of Iyengar yoga, a type that focuses on alignment, offered lasting benefits for women with rheumatoid arthritis. After two months, participants reported less pain, disability, and fatigue, as well as better general health, mood, and quality of life.

One of the great things about yoga is that you can reap its benefits anytime, anywhere. "You don't have to be on a yoga mat to be practicing yoga," says Moonaz. "Standing in a grocery store line, you can think about your alignment, focus on your breath, clear your mind. Yoga can be practiced any time of day and in any circumstance."

And it's totally safe for people with RA, as long as it is adapted to an individual's needs, Moonaz says. When beginning, try types of yoga that allow for adaptations and promote slow transitions between poses.

However, Moonaz does offer a few precautions for those with RA who are interested in trying yoga: "Styles that are very fast and vigorous, such as power yoga or ashtanga, are probably not a good fit," Moonaz says. "And while restorative or Yin yoga styles can be great for stress management, they will not help to build the strength that is important for RA management and joint stability."

What to Know Before You Start

Many yoga poses can be beneficial to people with RA, but you should learn what is most comfortable, safe, and appropriate for you. Before beginning yoga or any exercise routine, it's important to consult your rheumatologist to determine what is safe. "Every pose has endless variations, and no single version will be right for everyone," Moonaz says. "This especially applies to people living with a condition like RA. Each student has to find the modifications that will allow them to get the most benefit from their practice without exacerbating their joint discomfort." For instance, you might use a chair or wall for support to help you balance during poses like kickstand tree, or you might use a yoga block during sun salutation to help you get closer to the floor.

Moonaz also stresses the importance of learning yoga from a skilled yoga teacher or therapist. Only then, she says, would it be safe to practice yoga at home.

Your yoga instructor or therapist can recommend the right equipment to help you practice yoga safely and make appropriate modifications. Basics include a yoga mat, a yoga block (you may substitute a pillow or rolled-up towel), and a yoga strap to help you reach and grip.

7 RA-Friendly Yoga Poses

Here are seven poses that may be helpful in easing your RA symptoms, and may be easily modified to accommodate your needs:

1. Chair pose. This pose helps to strengthen the lower body and improve overall function. Stand with your feet hip-width apart and sink your hips down as though you were going to sit in a chair. Keep your knees behind your toes and your thighs parallel. Breathing deeply and lengthening the spine, hold for 5 to 10 seconds.

2. Basic knee down lunge. This pose stretches the hip flexor muscles. Start out on hands and knees (tabletop position) and move one foot forward and place it between your hands, using a pillow, blanket, or folded edge of your yoga mat to cushion your back knee. Slowly lower your hips toward your front heel; your front knee stays directly over the front heel. You can place your hands on the floor, on blocks next to your front foot, or on the top of the front thigh — whatever is comfortable for you. Lengthen the tailbone down and hold your navel in; hold for 30 seconds and then switch sides.

3. Kickstand tree. This pose can boost balance, which Moonaz says can help increase confidence and reduce the chance of falling. Standing with feet together, turn one foot so that the heel rests against the ankle of the opposite foot, with toes on the floor. "Tree pose is often done with the foot on the opposite thigh, but start by just taking the heel to the opposite ankle, keeping the toes on the floor," says Moonaz. "You can try moving the foot up to the calf if that feels okay." Start with your arms against your sides, and then move them to the position that's most comfortable for you. That may be stretched overhead with shoulders relaxed, out to the sides, using a chair or wall for support, or simply resting your hands over your heart.

4. Wide-legged forward fold. This pose provides good stretching of the inner thigh muscles and adductors, or hip muscles, which helps support and strengthen the knees. Stand with feet wide apart (about the length of your inseam), with feet parallel so that your legs form an equilateral triangle, toes pointing forward or slightly in. Fold forward at the hips, resting hands on blocks directly beneath the shoulders, on the floor, or on the back of a folding chair placed in front of you if you experience tightness in the legs. Don't overextend the knees during this move.

5. Cobra. This pose helps to strengthen the muscles in the upper back, triceps, and hands, and it also stretches the hips and front of the torso. Lie face down with the tops of your feet pressed into the floor and legs straightened and taut until the kneecaps begin to lift off the floor. As you pull in your navel and tilt your tailbone toward your heels, lift forward with your chest and let the muscles of the upper back pull you into a small backbend. You may gently press your hands into the floor if you need to, but do not straighten your elbows (keep them bent). Keeping your gaze a few feet ahead of you, hold for 5 to 10 seconds.

6. Diaphragmatic breathing. You can do this pose while standing, sitting in a chair, or in any position that allows you to breathe comfortably. With your back straight, place a hand on your belly. Inhale and feel your belly expand as your lungs fill with air and the diaphragm moves down. Exhale, feeling your belly go back toward your spine. "Practice lengthening your breath, which counteracts the stress response and helps the body and mind to relax," Moonaz says.

7. Corpse pose with legs on chair. Use this pose to ease stress and offer relief for the muscles in the neck and lower back. Set up a folding chair (with the seat facing you) at the end of your yoga mat. Lie on your back with your butt near the legs of the chair and your calves resting on the seat of the chair (you can use a 2-foot high stack of firm pillows instead of the chair). If you like, place a small pillow or rolled towel under your head or cover your eyes with a cloth or eye pillow. Rest for at least 5 minutes.

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